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[Toxocariasis and functional intestinal disorders. Presentation of 4 cases]
Abstract
We report 4 cases of adults patients, suffering from irritable bowel syndrome, which had been attributed late to toxocariasis and for whom the treatment led to recovery. Hypereosinophilia was present only in 3 cases. These cases show that toxocariasis is not limited anymore to its two classical expressions: visceral larva migrans and ocular toxocariasis. So it is useful to think of it to confirm and treat it in the case of patients suffering from irritable bowel syndrome. This enables shorter diagnosis delay (14 months in average for our patients) and this is essential for therapeutic efficiency.
... With regard to the response on human toxocariasis being a factor in the aetiology of irritable bowel syndrome (Konate et al. 1996), jaundice (Hartleb and Januszewski 2001) and arthritis (Rayes and Lambertucci 2001;Viola et al. 2016), the participant favourable response (i.e. answering yes) was around the 23-26% mark, significantly less than response to fever and abdominal discomfort. ...
Human toxocariasis is a zoonotic infection with global and regional impacts. Worldwide it is underestimated and clinically overlooked. Medical practitioners are generally unaware of the extent of the resulting disease spectrum. The objective of the study was to assess knowledge and disease awareness among medical practitioners in Aseer, south-western Saudi Arabia. A questionnaire addressing knowledge about the parasite, its visceral larva migrans and the disease spectrum generated was used to interview participants. The study included 285 participants. In answer to the question what is toxocara, only 27%, answered correctly that it is a nematode, paediatricians being the majority. With regard to years of experience among participants, 56.8% of those who answered correctly had less than 5-year experience, as opposed to 35.4% for those with more than 10-year experience. The cumulative awareness about the disease manifestations and spectrum, i.e. those who knew, was less than 30% across specialties and years of experiences. Lack of awareness regarding Toxocara infection and the disease spectrum it can generate is evident. The consequence for such lack of knowledge within our practising medical community is simply unacceptable as it might translate into misdiagnosis and consequently misguided treatment.
... La infección parasitaria por T. canis en humanos es asintomática usualmente (68,112). La toxocariosis asintomática diagnosticada por serología positiva ocurre principalmente en infecciones viejas y puede o no estar acompañada de eosinofilia (113,114). Las larvas de Toxocara pueden ser reactivadas en cualquier tiempo para luego migrar (56). ...
RESUMEN.- Se abordaron las principales características biológicas y ecológicas de Toxocara canis, resaltando su clasificación taxonómica, morfología y relación con el medio ambiente. Sobre la interacción de este parásito con los hospedadores definitivos (cánidos) y parténicos (humanos) se consideraron su ciclo biológico, patogenia, características clínicas, diagnóstico, epidemiología, control y pronóstico. ABSTRACT.- In the present article was broached the main biological and ecological characteristics of Toxocara canis, taking in consideration its taxonomic classification, morphology and relationship with the environment. On the aspect concerning to the interaction of this parasite with the definitive host (canids) and the paratenic host (humans) they were considered its biological cycle, pathogeny, clinical symptoms, diagnosis, epidemiology, control and prognosis.
... При описания о т нас случай на системна форма се наблюдават всички те зи оплаква ния, съчетани с алергичен екзантем, неспецифична ди ария, фебрилитет, хипергамаглобулинемия и рентгенологични данни за пневмония, описвани к а то домини ращи и о т други автори (1,4,24,30,31). Подобно на на шия пациент рецидивиращата коремна болка е описа на и о т други колективи к а т о начален и водещ симп то м при различни клинични форми на токсокароза (22,28). При с кр и т и т е форми т я създава сериозни диагнос тични затруднения, особено к о га то е самостоятелен симптом. ...
Toxocariasis is zoonotic disease caused by the infection of humans with second-stage larvae of Toxocara species. Four clinical forms have been recognized in humans: (I) systemic forms: classical visceral larval migrans (VLM) and incomplete VLM; (II) compartmentalized forms: ocular and neurological toxocariasis; (III) covert toxocariasis; and (IV) asymptomatic toxocariasis. This paper describes the occurrence of familial toxocariasis in three close relatives: 2-years boy with systemic VLM and his sister and mother with asymptomatic toxocariasis. Medical history in the boy included geophagia, fever, anorexia, abdominal pain, urticaria, hepatomegalia, leukocytes, hypergammaglobulinaemia and X-rays pulmonary involvment. The cases with asymptomatic toxocariasis included only eosinophylia. The diagnosis was confirmed by ELISA. The patients received oral albendazole - two 10-days courses in the boy and one 5-days course in the rest. In the posttreatment follow-up, clinical improvement and a decrease in eosinophilic count were observed. Authors conclude that eosinophilias in children should be examined serologically for toxocariasis. Authors concluded also hematological and serological screening to be proceeded in all members of families where cases of toxocariasis were found.
... A third condition, called "covert toxocarosis", might be caused to long-term exposure to migrating larvae in specific target organs. In children older than toddlers, this form presents vaguely with behavioral changes, seizures and sleep alterations, cough, asthma, abdominal discomfort, headache, while in adults it may present with weakness, rash and itching, abdominal pain and breathing distress [103][104][105][106][107][108]. ...
Ascarids and ancylostomatids are the most important parasites affecting dogs and cats worldwide, in terms of diffusion and risk for animal and human health. Different misconceptions have led the general public and pet owners to minimize the importance of these intestinal worms. A low grade of interest is also registered among veterinary professions, although there is a significant merit in keeping our guard up against these parasites. This article reviews current knowledge of ascarids and ancylostomatids, with a special focus on pathogenicity, epidemiology and control methods in veterinary and human medicine.
... T. canis has been suggested as an environmental risk factor for asthma among some inner-city populations (42). Similarly, in the brain, T. canis has been implicated as one of the causes of so-called idiopathic seizure disorders (9), as well as a cause of functional intestinal disorders (25). One study implicated Toxocara as a contributing factor in skin disorders of at least two varieties (prurigo and urticaria) (22), while another presented indirect evidence linking Toxocara infection with a form of eosinophilic arthritis (45). ...
Toxocariasis is caused by a series of related nematode species (ascarids) that routinely infect dogs and cats throughout the world. The eggs from these ascarids are common environmental contaminants of human habitation, due largely to the fact that many kinds of dogs and cats serve as pets, while countless others run wild throughout the streets of most urban centers. The eggs, present in dog and cat feces, become infectious within weeks after they are deposited in the local environment (e.g., sandboxes, city parks, and public beaches, etc.). Humans, particularly children, frequently ingest these eggs by accident and become infected. Infection in humans, in contrast to their definitive hosts, remains occult, often resulting in disease caused by the migrating larval stages. Visceral larva migrans (VLM) and ocular larva migrans (OLM) are two clinical manifestations that result in definable syndromes and present as serious health problems wherever they occur. Diagnosis and treatment of VLM and OLM are difficult. These issues are summarized in this review, with emphasis on the ecology of transmission and control of spread to both humans and animals through public health initiatives employing treatment of pets and environmental intervention strategies that limit the areas that dogs and cats are allowed within the confines of urban centers.
Toxocara infection traditionally has been associated with three possible manifestations: asymptomatic toxocariasis, visceral larva migrans, and ocular larva migrans. Recent literature, however, suggests that Toxocara infection may be associated with yet another clinical form, covert or “nonclassic” toxocariasis. This nonclassic toxocariasis is neither asymptomatic toxocariasis nor the full-blown syndrome of visceral or ocular larva migrans. Individuals with covert toxocariasis will not present with the full spectrum of symptoms but with a variety of individual and separate clinical entities, such as asthma, seizures, or neurocognitive disorders. Copyright © 2000 by W.B. Saunders Company
Irritable bowel syndrome (IBS) is common in western Europe and North America, and many aspects of its epidemiology, risk factors, and natural history have been described in these regions. Recent data suggest, however, that IBS is also common in the rest of the world and there has been some evidence to suggest some differences in demographics and presenting features between IBS in the west and as it is experienced elsewhere. The World Gastroenterology Organization, therefore, established a Task Force comprising experts on the topic from all parts of the world to examine IBS from a global perspective. IBS does, indeed, seem to be common worldwide though with some significant variations in prevalence rates between regions and countries and there may well be some potentially interesting variations in presenting symptoms and sex distribution. The global map of IBS is far from complete; community-based prevalence data is not available from many areas. Furthermore, while some general trends are evident in terms of IBS impact and demographics, international comparisons are hampered by differences in diagnostic criteria, study location and methodology; several important unanswered questions have been identified that should form the basis for future collaborative research and have the potential to shed light on this challenging disorder.
To study the role of human toxocariasis in the pathogenesis of pyogenic liver abscess.
We compared the serology for toxocariasis and serum levels of IgE in 16 patients with pyogenic liver abscess to those in 32 matched (age and gender) controls to define the possible association between these two entities.
The serology for toxocariasis was positive in 10 of 16 patients compared with 4 of 32 controls. The relative odds and 95% confidence interval (conditional logistic regression), comparing cases and matched controls, was significant (1.4; 95% confidence interval, 1.1-1.7) for Toxocara serology. Regarding IgE serum levels, there was no difference between cases and controls.
Human toxocariasis can be one of the predisposing causes of pyogenic liver abscess, especially in tropical countries in which this parasitic disease is common. Treatment of human toxocariasis may prevent morbid complications like hepatic abscess and should be considered in patients with clinical and/or serological evidence of Toxocara infection.
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